I've just finished reading the novel after years of enjoying the film, and the glaring differences between the book and the film are almost as fascinating as the themes that both products share. They are both about the institutional experiences of a woman following a nervous breakdown, and they both give insights into what is effective and what is counterproductive when treating mental illness, but when you compare the book and the film you learn an awful lot about Hollywood -- both then and now -- and about what happens when men who haven't been there adapt a book by a woman who has, and about the fundamental differences between life, art, and entertainment. Mary Jane Ward's fictionalized account of her own experiences is the life and the art...the movie is the entertainment.
I've loved the movie since I first saw it as a teen, and there's no doubting it had an impact on American policy regarding state-run institutions (though how much impact is up for debate). It's heart-wrenching and quite beautiful. Olivia de Havilland -- as protagonist Virginia Cunningham -- is an absolutely jittering wreck and she more than earned her Academy nomination. Helen Craig is also excellent as the vicious Nurse Davis, and Betsy Blair is also pretty spectacular as the silent and dangerously bottled-up Hester. You might also recognize Marie Blake as "Patient Awaiting Staff," twenty years before she became Grandmama in The Addams Family (if there's anybody you'd expect to see in an asylum, it's her!)
But one thing always bothered me about the movie: Sigmund Freud is practically a co-star. His picture hangs on the wall of saintly Dr. Kik's office, overseeing endless psychotherapy sessions and actually taking center stage during the final, Perry Mason-ish explanation that Virginia's problems started when she wasn't given enough affection as an infant. You see, interspersed with gritty scenes of institutional life are long sequences when Dr. Kik probes Virginia's childhood. She had a nervous breakdown because -- in a textbook case of Freudian psychology -- she transferred her love from a cold mother to a warm father, then hated him when he sided with her mother, then felt guilty because he died after she wished he was dead, then felt even guiltier because she accidentally caused the death of a father-surrogate fiancee.
This always seemed like so much bullsh*t to me, even more so after many years studying Psychology (including All Things Freud) in University. So I was wary about reading the book...if the Freudian angle was so significant in the movie, imagine how much Elektra complex backstory I'd have to wade through in the book?
Well, I finally read the book, and the answer is: none. Oh, there IS a Dr. Kik in the book, and he IS a Freudian therapist...but--
(are you ready for this?)
--in the book, Virginia only gets well when she is TRANSFERRED TO A DIFFERENT DOCTOR AND HAS LEARNED TO STOP EXPECTING DR. KIK TO ACTUALLY BOTHER TO HELP HER.
If you've seen the movie, think about that for a second. Mary Jane Ward -- who WAS Virginia Cunningham, for about 18 terrible months of her life -- credits Dr. Kik's psychotherapeutic approach with actually HOLDING HER BACK. By insisting that Virginia's nervous breakdown was the result of guilt about the death of her fiancee after a long illness and her subsequent marriage to her fiancee's friend, Dr. Kik did nothing but chase his tail while neglecting what Virginia REALLY needed...
...which was a healthy environment, an understanding ear, a realistic assessment of her capabilities, and some frigging books to read. Instead, she was kept underfed and cold in a succession of wards where the staff were too busy to notice that she wasn't as capable as they thought she was, then she was punished horrifically for falling short of their (and Dr. Kik's) expectations. She spent the entire time wearing dirty clothes, sitting around women with unspecified skin conditions ("Not syphilis!" says one doctor), usually on the floor, with nothing to occupy her day except confusion and utter boredom. In fact, she suspects that many of the women in Ward 33 (where you're sent if you've been at the institution for more than a year) talked to themselves and created imaginary friends because they had nothing else to occupy their minds.
I mentioned horrific punishment. Some of Virginia's earliest memories of the institution -- all of which are muddled and foggy -- are of a succession of shock treatments. Later she is subjected to the dreaded "tubs," continuously flowing baths that were meant to sedate patients, but involved them basically being wrapped in canvas and submerged up to their necks in tepid water.
The worst torture in the book, however, and one that was whispered among the patients as the ultimate punishment for disobedience: "packing." This was a hydrotherapeutic technique called a "wet sheet pack," where the patient was wrapped in cold sheets, around which were wrapped blankets, then held down on a rubber mat by series of tight sheets over the body.
I suppose there's a fine line between shocking a person to attention and teaching them to avoid terrible punishments, but there's no indication in the book that these treatments helped Virginia (in fact, whereas in the movie the shock treatments are administered as a last resort and are presented as helping Dr. Kik "make contact" with Virginia, in the book it seems that Virginia was getting them constantly since her arrival, and she suggests they may be blamed for much of her disorientation and memory loss).
So if the point of the movie was that psychotherapy and gentleness helps patients and that institutions need to be run with more consideration, what is the point of the book? Well, it's pretty much the same point, except for two things: psychotherapy is barely mentioned, and the entire situation is much less black and white than it is in the movie. There's no explanation for the onset of Virginia's illness -- thyroid trouble and difficulty adapting a life in New York City are the primary suspects -- and even less a resolution for why she actually got better.
In the movie, her recovery is solely the result of Dr. Kik's miraculous unraveling and exposure of Virginia's background. There is absolutely nothing like that in the book: maybe it just took eighteen months for her to recover, or maybe the treatments (and the endless doses of paraldehyde) DID help her focus. A contributing factor seems to have been diversionary and social occupational therapy that she could actually perform, as opposed to types of work that she was incapable of doing properly due to her well-hidden confusion (or -- in the case of the dreaded floor polisher -- her lack of upper-body strength).
What IS apparent in the book are the signs that she's getting better: she begins to understand jokes and she actually starts to find them funny. She starts engaging in the only sort of therapy she's allowed: "thinking therapy." And -- as is touched on in the movie -- she starts to become selfish, as result of her renewed acquaintance with time:
The softness is leaving. The sympathy. Yes, and the generosity...I no longer distribute cigarettes the way I used to. it is a queer way to judge your sanity...I am able now to take heed of the day to come. I have three cigarettes and if I look ahead I'll see that I cannot order more until the day after tomorrow. Therefore I shall not share my supply but I shall hoard it so that each day I can be sure of having one smoke. That, dear lady, is sanity.Incidentally, sympathy and generosity are presented as contributing factors to the decline of Miss Sommerville from nurse to patient. The nurses in the book are simply too busy to be able to really help anybody (let alone everybody), and poor Miss Sommerville finds herself walking around the ward keeping track of everybody's bowel movements. As an indication of the differences between a gritty novel and a slick Hollywood film, consider Miss Sommerville in the film: she takes people's temperatures. The film also neglects other significant themes in the book: Virginia's amusing anecdotes about her "True Trotskyite" friends, her less amusing anecdotes about the bathroom arrangements in the institution, and the plight of black patients dealing with white nurses.
You should read the book if you find the subject even remotely interesting. It is superbly written and surprisingly funny -- all hilarious scenes from the movie have been taken word-for-word from the book, including the repartee about "The Hopeless Diamond" -- and it is REALLY gripping from beginning to end. Unlike the movie character, the Virginia in the book is not a cringing little kitten looking for daddy to save her (or husband or therapist, which amount to the same thing). The book's Virginia (that is, Mary Jane Ward) is terrified on the inside but visibly strong and capable (which is ultimately part of her problem).
As a hilariously ironic indictment of the movie's deviations, I give you the following dialog from the book:
Well, the hell with my subconscious. What I'm interested in is getting the old conscious to working again. You know, maybe my subconscious did cook up something like Dr. Kik said, but if it did I'm sure it was for a novel. I always did have a secret, anyhow I hoped it was secret, ambition to write tripe.Bonus Memories From the Psychiatric Hospital
For several months during the early '90s I volunteered in the psychiatric ward of a local hospital. My job was to help manage recreational activities for the patients on Sunday mornings.
Since I was the new volunteer I was required to take direction from the more keen and seasoned organizers. We'd breeze into the recreation room at 10am, and one of the announcers would say "Hello everybody! Here are some old magazines and some Bristol board. Let's make collages about our favourite sports!"
I couldn't believe it. The patients were uniformly either depressed elderly people or depressed university students. They were adults, and we were telling them to make COLLAGES.
And they WOULD. Next week the announcer would say "Let's make decorative coat hangers!" and these grandparents and adolescents would shamble up and start working with the yarn. I stood there among the cardboard crafts and thought: these people need dignity, and we are stealing it from them. We are making them worse.
So I spoke up. "Here's a deck of cards. Does anybody want to play cards, or chess?" and people would stare at me in amazement. One University student -- a major in NUCLEAR PHYSICS -- came up to me and whispered "THANK YOU SO MUCH" and we played chess together. When I asked him why people came to these things even though they hated them so much, he said something that pretty much convinced me that I was in the wrong major: "If we don't show up, they think it's an indication that we're antisocial and getting more depressed."
You get that? These people were being trained to do something totally abnormal -- to take part in a degrading activity that they hated -- under the belief that doing so would make them BETTER. Their sanity was judged in inverse proportion to how insane they behaved. I was immediately reminded of the rug scene in "The Snake Pit," a huge rug in the middle of the dayroom that the patients were forced to huddle AROUND instead of standing ON because the nurses were afraid of getting it dirty.
Here's what I read today in "The Snake Pit," a book I wish I'd read a long time ago:
That afternoon she was invited to a popcorn party. [Nurse] Vance thought that was just too super for words. When the Popcorn Ladies were summoned, Virginia stumped over to the door to join the group. If you were going to get out of this prison it looked as if you'd have to do what they said, even to the extent of going to a damn popcorn party.I guess some things never change...but they should. Anyway, I already hated the place because they kept the electroshock therapy bed in the entertainment room beside the ping pong table. When one of the organizers said "This week I've got a Jane Fonda workout tape...we're going to march around the room!" I quit.